Diastolic and systolic blood pressure time in target range as a cardiovascular risk marker in patients with type 2 diabetes: A post hoc analysis of Action to Control Cardiovascular Risk in Diabetes (ACCORD) blood pressure (BP) trial
Authors' conclusion
In patients with diabetes, TTR of diastolic and systolic BP was independently associated with lower risks of major outcomes. The diastolic BP within the optimal target range was considerably important for reducing the risk of myocardial infarction, even when systolic BP was under stable control.
Study context
- Population
- Patients with T2D from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) BP trial; diastolic target 70 to 80 mm Hg; systolic target 120 to 140 mm Hg (standard) and 110 to 130 mm Hg (intensive therapy)
- Participants
- 4,651 patients
- Comparison
- Higher vs lower diastolic and systolic BP time in target range
- Primary endpoint
- Primary outcome (cardiovascular)
Primary result
As reported in the abstract
Primary outcome per 1-SD increase of diastolic TTR
HR (95% CI 0.74-0.91), P < 0.001
0.82
HR (95% CI 0.77-0.95), P = 0.0044
0.86
Further findings
Nonfatal MI per 1-SD increase of diastolic time in target range (TTR)
- HR (95% CI 0.69-0.91), P < 0.001
- 0.79
- Adjusted for covariates
Systolic TTR and cardiovascular outcomes
- Systolic TTR significantly associated with various cardiovascular outcomes in fully-adjusted models
- P ≤ 0.016
MI by systolic BP average
- Diastolic TTR sustained significance in MI when systolic BP average was higher than 120 mm Hg
Original publication
Diastolic and systolic blood pressure time in target range as a cardiovascular risk marker in patients with type 2 diabetes: A post hoc analysis of ACCORD BP trial. Diabetes Res Clin Pract. Published 15 July 2023. doi:10.
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